The chance of you, a co-worker, parent, or even a student surviving such an incident could rest entirely on whether someone in the vicinity has access to a simple, often misunderstood, device.
Check out Daniela’s full article in our latest print issue.
Automatic External Defibrillators (AEDs) are devices that assess a heart’s rhythm, provide instructions to the user, and where applicable provide a shock to the arresting heart. AEDs are extremely user-friendly as they are designed for anyone to be able to use them in a cardiac emergency with no formal training required.
However, misconceptions around their functionality mean too many people might not think to reach for one when called upon and there simply aren’t enough of them around. This issue, we spoke with some key AED suppliers to uncover some of these misconceptions and offer informed industry perspectives.
Present statistics show that only 5-10 percent of people who experience a cardiac arrest survive because of response time delays – every minute counts and waiting for an ambulance is usually too late. For every minute that defibrillation is delayed, the survival rate drops by 10 percent. Stationing AEDs in workplaces, schools, public spaces, and other highly populated areas could significantly increase someone’s chance of survival in this case.
AED Authority’s Joanne Feehan explained: “There are a lot of myths and misconceptions around AEDs but one of the most common is that you could accidentally shock someone or yourself and cause harm. You cannot do this. AED pads measure the person’s heart rhythm and will only ever shock if needed.
“All AEDs do the same thing: deliver life-saving shocks to restore regular heart rhythm. However, they each do it slightly differently. In choosing an AED program for a school, it important to consider the model’s ease-of-use, its ability to cater to both children and adults, and the level of experience of the likely first responder. I.e., are they first aid trained?”
Dush Dedic from St John Ambulance Australia (VIC) noted: “One of the main misconceptions is that children do not have sudden cardiac arrests, this is not true. Although it might not be as common as it is in adults, it does still occur, so it is vital that schools are fully prepared for this situation.”
Intensive Care Paramedic with over thirty years of paramedicine experience, and managing director of the Defibshop, Carpet Hughes emphasised the importance of simplicity for schools. He said: “Choosing one for instance that has one set of defibrillation pads for both adults and paediatrics makes using the device easy and saves confusion about what pads to use.”
Offering some quick tips, he said to make sure the devices are accessible: “Make sure the cabinet or bracket is easily visible and identifiable, and that the cabinet door can be opened easily. Make sure you change the cabinet alarm battery annually (if fitted). A good time is when you do your smoke detectors! Make sure the cabinet or bracket is kept clean and under cover (an awning, for example, in outdoor locations – wall brackets are for indoor use only!).”
He added some warnings too: “Don’t lock the cabinet or bracket in a room, office, first aid room or similar. Don’t locate it too high or place items in front of the cabinet or bracket – leave free space around for access. Don’t turn the cabinet alarm off permanently (if fitted), and don’t install it in permanent sunlight or heat if possible. Also, don’t obstruct fire equipment and extinguishers! That is illegal.” His top tip is to make sure “the bottom edge of the cabinet or bracket is 1200 to 1500mm from the floor and to locate it where most people will know, such as the entrance foyer, outside first aid room (unless first aid room is not lockable), or near lifts”.
Discussing the responsibilities schools have with us, Joanne said: “Defibrillators (PADS) are designed to be used by both trained and untrained personnel; however, basic life support/first aid training will benefit any first responder, particularly in terms of the delivery of CPR, which needs to be done in conjunction with using a defibrillator. I recommend that everyone in the school community becomes familiar with the chain of survival. Put simply, the chain of survival is a serious of steps (forming a virtual ‘chain’) which if followed promptly, give the best chance of survival from a cardiac arrest.
“Schools have an obligation under the Occupational Health and Safety Act to ensure they have sufficient staff trained in first aid and CPR. Both the Australian Resuscitation Council and Safe Work Australia recommend CPR skills should be refreshed at least annually.”
“Access is the most important factor in the placement of AEDs as using defibrillation within three minutes of a sudden cardiac arrest is crucial. That means the AED should be located within 1.5 minutes of the victim in case you need to go from the victim to the AED and back. Also consider locations where the risk of incident is higher. With the above in mind, arming yourself with a stopwatch and floor plan will help map out the best locations. AEDs should be clearly signed, and their locations shared with the school community.”
Dush also clarified that “when purchasing an AED for a school, it’s important to consider the size of the school and the number of students, visitors, and staff it has”. He explained: “Primary schools should also look at ensuring the device they purchase has paediatric pads, as adult pads will not be suitable on smaller children due to body size requiring a lower shock.
In terms of training for staff and school personnel, he added: “It is recommended that all staff have at least formal CPR training that includes AED training. There should also be selected first aiders who have completed Provide First Aid and Provide Cardiopulmonary Resuscitation (CPR). Basic first aid training must be completed every three years, while a refresher course in CPR must be completed annually. Although it is not mandatory for schools to have an AED, it is highly recommended as it may be needed at any time and it significantly increases the chance of survival if someone suffers a cardiac arrest.
“Some AEDs include CPR feedback to help the responder and provide useful prompts, such as ‘press faster’ or ‘press softer’ which improves the quality of CPR during what can be a stressful scenario. All AEDs perform self-maintenance checks on a daily, weekly, and monthly basis to ensure they are ready for use. If the machine fails part of the test, the machine will beep to alert you there is a fault with the machine. St John recommends a weekly inspection be performed on the machine to ensure the machine has not failed a self-check; this inspection only takes a minute to complete. Batteries and pads will need to be replaced from time-to-time depending on the type of device.”
Carpet added: “In terms of ‘servicing’, that is up to each individual school, but a service will include making sure the unit is delivering the correct amount of energy with each shock. It runs the unit through specific cardiac rhythms to make sure it will identify properly any life-threatening rhythms that need defibrillation to save a patient’s life. Servicing of your AED fleet for your school is also a risk management process. By making sure your AEDs are serviced properly and provided with a report, you know the unit will work when needed for that lifesaving moment.”